Osteoarthritis: What is the Latest Evidence?
I recently attended the GLA:DTM (Good Living with Osteoarthritis from Denmark) course for physiotherapists in Australia. The course provided the latest evidence for treatment of patients with hip and knee osteoarthritis.
Osteoarthritis is a disease that mainly affects the articular cartilage in the joints (commonly in the hips and knees). It's a very common problem that can cause pain and disability particularly in older people (as your bones tend to weaken with age).
The following is a brief list of common signs and symptoms that people present with when they are suffering from osteoarthritis...
- Pain with weight-bearing
- Stiff and unstable leg
- Knee giving way
- Crunching or clicking noises
- Finding it hard to walk up and down stairs, or get from sitting to standing
- Occurs with deformities like knock-knees or bowleg.
- Pain can be located outside the hip, deep in the groin or down the thigh
- Sometimes pain is not in the hip, but instead on the inside of the knee
- Reduced range of motion in the hip joint
- Trouble getting in and out of a car, putting on socks, picking things up from the floor.
- Step length will often get shorter when walking
- It may be hard for you to straighten your hips, so you may tend to bend forward when walking.
There are two types of factors that can influence your risk of developing osteoarthritis:
|Age: More common after the age of 50|
Sex: Women more likely than men
Heredity: Runs in families
|Obesity: Due to increased load and other|
inflammatory factors associated with being
Physical inactivity: Cartilage needs load to be
Muscle weakness: Joints need support from
muscles to move effectively
The clinical guidelines for osteoarthritis are based on a three-tiered system:
Tier 1: Treatment options that should be offered to ALL patients suffering from osteoarthritis...
- Education regarding the physiology of osteoarthritis, pain and ways to cope
- Exercise: We will give you the option to undertake an appropriate exercise program for your specific problem
- Weight Control: We will discuss weight control, if this is a problem for you, advising on a weight loss program, dietitian or similar.
Tier 2: Treatment options that should be offered to SOME patients suffering from osteoarthritis...
- Pharmacological pain relief (medications, injections)
- Aids (including walking stick, frame, orthotics etc.)
- Passive treatment (such as massage) provided by a therapist
Tier 3: Surgery: Treatment options for those with VERY SEVERE symptoms (usually only 10-15% of patients)
- Joint replacement
- Osteotomy: a wedge of bone is surgically removed
Source: GLA:D Australia: https://gladaustralia.com.au/
As you can see, it's important that tier one options for treatment should be offered before the second and third tiers. If the first line of treatment doesn’t lead to a satisfactory outcome then you can progress through the tiers until symptoms are managed. It's important to note that exercise, education and weight loss are always included in treatment for osteoarthritis no matter when you come and see us.
In my next blog I will start to address further the exercise component of the osteoarthritis treatment plan. As a physiotherapist this is the area that I am passionate about and I enjoy helping patients to increase function, reduce pain and improve quality of life.
If you would like further information about the GLA:DTM program please visit their website, click here
Please note that information provided in this article is general advice only. For individual advice, we recommend a consultation. For more information or if you are experiencing symptoms of osteoarthritis and would like to book an appointment, you can…
- Contact our friendly reception team on 9822 4999 (Armadale) or 9486 0512 (East Melbourne)
- Book online. Select ‘make a booking’ in the top right-hand corner of the screen and follow the prompts
- Email us on firstname.lastname@example.org